One session and I still bet your doctor will not be doing this for 50 years.
Single Session of Dual-tDCS Transiently Improves Precision Grip and Dexterity of the Paretic Hand After Stroke
- Stéphanie Lefebvre1,2
- Jean-Louis Thonnard, PhD2
- Patrice Laloux, MD, PhD1,2
- André Peeters, MD3
- Jacques Jamart, MD, MSc1
- Yves Vandermeeren, MD, PhD1,2
- 1Université Catholique de Louvain (UCL), Yvoir, Belgium
- 2Institute of Neuroscience (IoNS), Université Catholique de Louvain (UCL), Brussels, Belgium
- 3Unité Neuro-Vasculaire, Service de Neurologie, Bruxelles, Belgium
- Yves Vandermeeren, MD, PhD, Department of Neurology, CHU Mont-Godinne, Université Catholique de Louvain (UCL), Avenue Dr G Therasse, 5530 Yvoir, Belgium. Email: yves.vandermeeren@uclouvain.be
Abstract
Background.
After stroke, deregulated
interhemispheric interactions influence residual paretic hand function.
Anodal or cathodal transcranial
direct current stimulation (tDCS) can rebalance
these abnormal interhemispheric interactions and improve motor function.
Objective.
We explored whether dual-hemisphere tDCS (dual-tDCS) in participants with chronic stroke can improve fine hand motor function
in 2 important aspects: precision grip and dexterity. Methods.
In all, 19 chronic hemiparetic individuals with mild to moderate
impairment participated in a double-blind, randomized trial.
During 2 separate cross-over sessions (real/sham),
they performed 10 precision grip movements with a manipulandum and the
Purdue Pegboard Test (PPT) before, during,
immediately after, and 20 minutes after dual-tDCS applied simultaneously
over the
ipsilesional (anodal) and contralateral (cathodal)
primary motor cortices.
Results.
The precision grip performed
with the paretic hand improved significantly 20 minutes after dual-tDCS,
with reduction of
the grip force/load force ratio by 7% and in the
preloading phase duration by 18% when compared with sham. The dexterity
of
the paretic hand started improving during dual-tDCS
and culminated 20 minutes after the end of dual-tDCS (PPT score +38% vs
+5% after sham). The maximal improvements in
precision grip and dexterity were observed 20 minutes after dual-tDCS.
These
improvements correlated negatively with residual
hand function quantified with ABILHAND.
Conclusions.
One bout
of dual-tDCS improved the motor control of precision grip and digital
dexterity beyond the time of stimulation.
These results suggest that dual-tDCS should be
tested in longer protocols for neurorehabilitation and with moderate to
severely
impaired patients. The precise timing of
stimulation after stroke onset and associated training should be
defined.
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